An International Expert-Based Consensus on the Treatment Strategies for Early and Locally Advanced Rectal Cancer

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Tatar C., Bişgin T., Erenler Bayraktar İ., Canda A. E., Yıldırım A. C., Cakcak İ. E., ...Daha Fazla

XX. Ulusal ve III. Uluslararası Türk Kolon ve Rektum Cerrahisi Kongresi, Antalya, Türkiye, 16 - 20 Mayıs 2025, ss.52-53, (Özet Bildiri)

  • Yayın Türü: Bildiri / Özet Bildiri
  • Basıldığı Şehir: Antalya
  • Basıldığı Ülke: Türkiye
  • Sayfa Sayıları: ss.52-53
  • Gazi Üniversitesi Adresli: Evet

Özet

Objective: This study aimed to establish an international expert-based consensus on the preferred treatment strategies for early and locally advanced rectal cancer, considering the evolving landscape of non-operative management and the importance of multidisciplinary treatment planning.

Materials-Methods: A Delphi study was conducted with a steering committee of 12 members who performed a literature review on treatment strategies for early and locally advanced rectal cancer and created a survey distributed to an expert panel. The survey included 49 questions, with responses informing the consensus statements. A total of 44 experts participated, providing insights and describing their current practices on multidisciplinary team involvement, what they felt the minimal rectal cancer case volume should be, the methods they use for staging, the techniques they employ for preoperative bowel preparation if they perform it, their views on partial and complete mesorectal excision techniques, when they used local excision, and their thoughts on total neoadjuvant therapy (TNT) and non-operative management (NOM).

Results: The consensus emphasized the importance of multidisciplinary team assessment and decision-making and surgical expertise in TME. Structured reporting of MRI staging of rectal cancer was recommended. TNT was favored for high-risk tumors, and non-operative management was recommended when clinical complete response is achievedafter TNT. Surveillance protocols for NOM were defined, and the role of biopsy in near-complete clinical response was discussed.

Conclusion: The consensus provided a comprehensive guide for the treatment of rectal cancer, highlighting the importance of multidisciplinary management, the role of TNT in achieving organ preservation, and the implementation of strict NOM surveillance protocols. The findings contribute to the optimization of patient care and standardization of treatment strategies.